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General NPI Number Information
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NPI Number | 1558707448
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY ASSOCIATES OF TAMPA BAY LLC
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 2901 W BUSCH BLVD SUITE 916-E
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City | TAMPA
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State | FL
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Zip | 33618-4523
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Country | US
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Telephone | 813-293-0409
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Fax |
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Provider Business Mailing Address
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Address Line | 3837 NORTHDALE BLVD SUITE 367
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City | TAMPA
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State | FL
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Zip | 33624-1841
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | HEATHER RIIKONEN
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Credential | AUD
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Telephone | 813-293-0409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY986
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License Number State | FL
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